T follicular helper cells (T): From physiological to pathological aging.

The fraction that the elderly represent in the world's population is growing rapidly; numerous alterations that impact all organs and systems, including the immune system, are related to aging. A complex process common in the elderly, known as immunosenescence, is characterized by a decreased ability to respond to vaccination as well as an increased risk of bacterial and viral infections, autoimmune, cardiovascular and neurodegenerative diseases. These processes are associated with alterations in the innate and adaptive immune system and lead to a condition of chronic low-grade inflammation, referred to as inflammaging.

Pupil dilation as a marker of attention/effort in aging and mild cognitive impairment.

Pupil dilation (PD) can be easily measured and reflects responses to subjectively salient or cognitively demanding events. It therefore holds promise as a cognitive marker especially for individuals with mild cognitive impairment (MCI) or other neurodegenerative conditions with restricted abilities to respond in cognitive assessments. We assessed PD during two tasks, an oddball task for investigating attentional allocation and a Simon task which additionally allows for investigating cognitive effort in younger adults (YAs), older adults (OAs), and patients with MCI.

Effect of infections, DNA methylation and telomere length on frailty trajectories in hospitalized older patients: the INFRAGEN study protocol.

Background: Infectious diseases are among the most common causes of hospitalization in older adults and may lead to a high burden on the individual's health and healthcare system. However, it is unclear whether and to which extent these events might affect frailty, fastening its development or hampering its reversion. The aims of the INFRAGEN project are 1) to assess the impact of acute infections on frailty trajectories in older inpatients, and 2) to evaluate the modifying effect of sociodemographic, clinical, functional, and genetic/epigenetic factors on that association.

Unraveling functional decline: the relationship between muscle strength and ultrasound evaluation of biceps brachii thickness.

Skeletal muscle characteristics play a crucial role in understanding physical capacity, overall health, and outcomes. Muscle strength and muscle mass are key indicators of muscular function and sarcopenia. While previous research has explored biceps brachii muscle characteristics in isolation, there is a notable gap in comprehensive studies examining the direct correlation between biceps brachii muscle thickness (BMT), as measured by ultrasound, and muscle strength.

The role of diabetes mellitus on delirium onset: a systematic review and meta-analysis.

Background: Delirium may develop in association with an underlying cardiovascular or cerebrovascular disease and complicates one out of three medical admissions representing a significant economic burden for healthcare systems. However, a clear relationship between delirium onset and diabetes mellitus has not been clarified. The purpose of this study was to explore the association between DM and delirium with the following aims: (a) to assess the incidence of delirium among DM patients (b) to assess the risk of delirium onset in patients with DM (c) to assess the role of anti-diabetic drugs on delirium onset.

Psychological Resilience and Personality in Mild Cognitive Impairment and Healthy Older Adults.

Objectives: Psychological resilience is the ability to cope with adversity and stressful situations, and it is considered a protective factor against cognitive impairment. This study compared resilience, personality, cognitive, and neuropsychological profiles of older adults with mild cognitive impairment (MCI) and a comparison group without cognitive impairment. Moreover, we evaluated clinical and personality predictors of psychological resilience in both groups.

Anticholinergic burden and behavioral and psychological symptoms in older patients with cognitive impairment.

Background: Drugs with anticholinergic properties are frequently prescribed to patients with cognitive impairment. The cholinergic system plays an important role in learning processes, memory, and emotions regulation. The aim of this research is to report use of anticholinergic drugs in a clinical population and to investigate the correlation between the use of anticholinergic drugs and the risk of presenting with more severe behavioral and psychological symptoms (BPSD).

Cognitive profile in burning mouth syndrome versus mild cognitive impairment: A comparative study.

Objectives: This study aims to assess and contrast cognitive and psychological aspects of patients with burning mouth syndrome (BMS-MCI) and geriatric patients (G-MCI) with mild cognitive impairment, focusing on potential predictors like pain, mood disorders, blood biomarkers, and age-related white matter changes (ARWMCs).

Methods: The study enrolled 40 BMS-MCI and 40 geriatric G-MCI, matching them by age, gender, and educational background. Participants underwent psychological, sleepiness, and cognitive assessment including the Mini-Mental State Exam (MMSE), Trail Making Test (TMT), Corsi Block-Tapping Task, Rey Auditory Verbal Learning Test, Copying Geometric Drawings Test, Frontal Assessment Battery, and Digit Cancellation Test.

Impact of serum leptin and adiponectin levels on brain infarcts in patients with mild cognitive impairment and Alzheimer's disease: a longitudinal analysis.

Introduction: The adipokines leptin and adiponectin have been associated with atherosclerosis and the risk of cerebral infarcts. Pre-clinical studies, however, suggest a protective role against ischemic brain damage. In this study we analyzed the relationship between serum leptin and adiponectin levels and the onset or progression of brain infarcts in subjects with mild cognitive impairment (MCI) and Alzheimer's disease (AD).

Atrial Fibrillation and Dementia: Focus on Shared Pathophysiological Mechanisms and Therapeutic Implications.

Objectives: Atrial fibrillation (AF) and dementia are highly prevalent chronic and debilitating conditions, especially affecting the older population. This review focuses on possible common pathophysiological mechanisms that could explain the association between the 2 conditions.

Design: Narrative review.

Intricate relationship between obstructive sleep apnea and dementia in older adults.

Numerous evidence reports direct correlation between cognitive impairment, Alzheimer's disease and sleep disorders, in particular obstructive sleep apnea. Both obstructive sleep apnea and Alzheimer's disease are highly prevalent conditions whose incidence increases with age. Several studies demonstrate how sleep-disordered breathing may lead to poor cognition, even though the underlying mechanisms of this association remain partially unclear.

Digital Health Service for Identification of Frailty Risk Factors in Community-Dwelling Older Adults: The SUNFRAIL+ Study Protocol.

This article reports the study protocol of a nationwide multicentric study in seven Italian regions aimed at assessing the effectiveness of a digitally supported approach for the early screening of frailty risk factors in community-dwelling older adults. SUNFRAIL+ is a prospective observational cohort study aimed at carrying out a multidimensional assessment of community-dwelling older adults through an IT platform, which allows to connect the items of the SUNFRAIL frailty assessment tool with a cascading multidimensional in-depth assessment of the bio-psycho-social domains of frailty. Seven centers in seven Italian regions will administer the SUNFRAIL questionnaire to 100 older adults.

Cardiac sympathetic innervation and mortality risk scores in patients with heart failure.

Introduction: In the risk stratification and selection of patients with heart failure (HF) eligible for implantable cardioverter-defibrillator (ICD) therapy, I-meta-IodineBenzylGuanidine ( I-mIBG) scintigraphy has emerged as an effective non-invasive method to assess cardiac adrenergic innervation. Similarly, clinical risk scores have been proposed to identify patients with HF at risk of all-cause mortality, for whom the net clinical benefit of device implantation would presumably be lower. Nevertheless, the association between the two classes of tools, one suggestive of arrhythmic risk, the other of all-cause mortality, needs further investigation.

Assessment Tools of Biopsychosocial Frailty Dimensions in Community-Dwelling Older Adults: A Narrative Review.

Frailty is a complex interplay between several factors, including physiological changes in ageing, multimorbidities, malnutrition, living environment, genetics, and lifestyle. Early screening for frailty risk factors in community-dwelling older people allows for preventive interventions on the clinical and social determinants of frailty, which allows adverse events to be avoided. By conducting a narrative review of the literature employing the International Narrative Systematic Assessment tool, the authors aimed to develop an updated framework for the main measurement tools to assess frailty risks in older adults, paying attention to use in the community and primary care settings.

Interleukin-17 (IL-17) triggers systemic inflammation, peripheral vascular dysfunction, and related prothrombotic state in a mouse model of Alzheimer's disease.

Alzheimer's disease (AD) is one of the most prevalent forms of neurodegenerative disorders. Previously, we have shown that in vivo administration of an IL-17 neutralizing antibody (IL-17Ab) rescues amyloid-β-induced neuro-inflammation and memory impairment, demonstrating the pivotal role of IL-17 in AD-derived cognitive deficit. Recently, AD has been recognized as a more intriguing pathology affecting vascular networks and platelet function.

Astrogliosis in aging and Parkinson's disease dementia: a new clinical study with C-BU99008 PET.

The role of astrogliosis in the pathology of brain aging and neurodegenerative diseases has recently drawn great attention. Imidazoline-2 binding sites represent a possible target to map the distribution of reactive astrocytes. In this study, we use C-BU99008, an imidazoline-2 binding sites-specific PET radioligand, to image reactive astrocytes in healthy controls and patients with established Parkinson's disease dementia.

Role of frailty on cardiac rehabilitation in hospitalized older patients.

Background: Cardiovascular diseases are the leading cause of mortality, morbidity, and disability in the world, especially in the older adults. A relevant proportion of patients admitted to Cardiac Rehabilitation (CR) may suffer from frailty, a complex geriatric syndrome with multifactorial aetiology.

Aims: The hypothesis underlying the study is that frailty complicates the management of older patients undergoing CR.

Muscle Ultrasound as Imaging Domain of Frailty.

Introduction: Frailty is a geriatric syndrome, a clinical state of vulnerability for developing dependency and/or death. Due to its multidimensional nature, Comprehensive Geriatric Assessment (CGA) constitutes the best strategy to evaluate frailty in older patients. Accumulation of deficits model synthesizes the global assessment of geriatric domains in the Frailty Index (FI) score.

Serum galectin-3 and aldosterone: potential biomarkers of cardiac complications in patients with COVID-19.

Background: Despite severe acute respiratory syndrome (SARS)-Coronavirus (CoV-2) primarily targeting the lungs, the heart represents another critical virus target. Thus, the identification of SARS-CoV-2 disease of 2019 (COVID-19)-associated biomarkers would be beneficial to stratify prognosis and the risk of developing cardiac complications. Aldosterone and galectin-3 promote fibrosis and inflammation and are considered a prognostic biomarker of lung and adverse cardiac remodeling.

The experiences of early career geriatricians throughout Europe during the COVID-19 pandemic.

The COVID-19 pandemic has severely affected older adults and brought about unprecedented challenges to geriatricians. We aimed to evaluate the experiences of early career geriatricians (residents or consultants with up to 10 years of experience) throughout Europe using an online survey. We obtained 721 responses.

The elderly at risk: aldosterone as modulator of the immune response to SARS-CoV-2 infection.

The elderly population is the most susceptible to SARS-CoV-2 infection and develops the worst clinical phenotype with severe pneumonia and cardiac complications. Older COVID-19 patients are also at higher risk of sudden death, mainly attributable to electrolyte disorders and to an uncontrolled inflammatory response. After the identification of ACE 2 as the receptor of SARS-CoV-2 in human cells, several research studies have focused on the role of the activation of Renin Angiotensin System in COVID-19 clinical course.

Diabetes Mellitus and Parkinson's Disease: A Systematic Review and Meta-Analyses.

Background: A link between diabetes mellitus (DM) and Parkinson's disease (PD) have been proposed but evidence are sparse and inconsistent.

Objective: Perform a systematic review of all evidence that link DM and PD characterising the prevalence of DM in PD patients, the risk of developing PD in DM patients and the influence of DM on PD severity and progression.

Methods: MEDLINE, Scopus, and Cochrane Library from inception to June 30, 2021 were searched.